The NM_000020.3: c.500C>G variant in ACVRL1 is a missense variant predicted to cause substitution of serine by cysteine at amino acid 167 (p.Ser167Cys). This variant is absent from gnomAD v2.1.1 (PM2_Supporting). This variant has been reported in a proband with a phenotype consistent of HHT (PS4_Supporting; PMID: 32300199, Internal lab contributors). The computational splicing predictor SpliceAI gives a score of 0.84 for donor loss, predicting that the variant disrupts the donor splice site of intron 4 of ACVRL1 (PP3). In summary, this variant meets the criteria to be classified as a variant of uncertain significance for autosomal dominant hereditary hemorrhagic telangiectasia based on the ACMG/AMP criteria applied, as specified by the ClinGen Hereditary Hemorrhagic Telangiectasia Variant Curation Expert Panel: PM2_Supporting, PS4_Supporting, PP3 (specification version 1.0.0; 1/4/2024).